SUD 101: Managing Common Psychiatric Conditions in Patients with Substance Use Disorders (2026)-Course Content

Video Transcription

Video Summary

This module explains how to recognize and manage common psychiatric conditions in patients with substance use disorders, using a case-based approach centered on “Anna,” a woman with opioid use disorder, trauma history, depression, PTSD symptoms, and possible bipolar disorder. The key message is that clinicians should ask, “What happened to you?” rather than only “What’s wrong with you?” because adverse childhood experiences strongly increase later risks for substance use, suicide, depression, anxiety, and chronic medical illness.<br /><br />The lecture emphasizes that psychiatric comorbidity is extremely common and often untreated. Depression, anxiety, PTSD, ADHD, and bipolar disorder frequently occur alongside substance use disorders, and missing them worsens outcomes, including relapse, overdose, and mortality. Suicide screening is essential, especially in opioid use disorder, where risk is especially high and overdose may represent hidden suicide intent.<br /><br />The module reviews efficient screening tools: PHQ-9, GAD-7, PC-PTSD-5, ASRS for ADHD, MDQ for bipolar disorder, and the Columbia Suicide Severity Rating Scale. It then outlines treatment: treat both substance use and psychiatric conditions together, without waiting for prolonged abstinence. First-line approaches include SSRIs/SNRIs and CBT for depression and anxiety, trauma-focused psychotherapies for PTSD, stimulant treatment when appropriate for ADHD, and mood stabilizers for bipolar disorder. It also covers substance-specific care such as buprenorphine, naltrexone, varenicline, contingency management, and insomnia treatments like CBT-I.<br /><br />Overall, the module teaches clinicians to screen systematically, treat early, refer wisely, and persist with chronic, integrated care.

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Keywords

substance use disorders

psychiatric comorbidity

opioid use disorder

trauma history

adverse childhood experiences

depression screening

PTSD symptoms

bipolar disorder

suicide risk

PHQ-9

GAD-7

integrated treatment

buprenorphine